vWF和GMP-140检测在心脏瓣膜置换术中变化的临床研究

目的 探讨心脏瓣膜病患者行人工机械瓣膜置换术前后凝血功能改变，为合理应用抗凝治疗提供更好的实验支持。方法 测定40例心脏瓣膜病患者术前、术后1d和术后3个月血浆纤维蛋白原（FIB）、vWF、GMP-140水平，并与性别、年龄相匹配的门诊其他类型手术对照组患者相比较。结果 换瓣膜组病人血浆FIB、vWF、GMP-140水平明显高于对照组，瓣膜病组换瓣术后1d、术后3个月FIB、vWF-GMP-140水平较术前升高，以vWF、GMP-140增高尤为显著（P〈0．05）。结论 瓣膜病患者体内凝血机制异常与内皮细胞受损，血小板活化，凝血功能激活等因素有关，瓣膜置换术可以改善患者心脏瓣膜的功能。但不能改变该类患者凝血机制的异常，合理运用抗凝治疗是必要的。

Clinical Significance of vWF and GMP-140 in heart Valve Replacement

Objective To study the change and clinical significance of FIB?vWF?GMP-140 level pre and postheart valve replacement treatment.To provide clinicians experimental data for post replacement anticoagulation treatment.Methods 40 patients received the heart valve replacement treatment,their FIB?vWF?GMP140 level were examined on the day~(-1),+1 and +90 and compared the results with the control group whose gender and age were matched.Results Patients who received the replacement treatment have the higher level of FIB?vWF?GMP-140 than the control group.FIB?vWF?GMP-140 level were much higher after the surgery in the same patient.vWF?GMP-140's changes were significance(P<0.05).Conclusion Heart valve diseases always combined with coagulation disturbance related to endothelium damage,platelet aggregation and hypercoagulable states.Heart valve replacement treatment can improve the heart function,can not relieve the coagulation disturbance.Postoperative anticoagulation treatment is very necessary.